Effects of high-efficiency centering pregnancy care combined with information-knowledge-attitude-practice health education on cesarean delivery on maternal request rate, maternal and neonatal health status and breastfeeding in primiparas / 中国实用护理杂志

Objective:To explore the effects of high-efficiency centering pregnancy care (CPC) combined with information-knowledge-attitude-practice (IKAP) health education on cesarean delivery on maternal request (CDMR) rate, maternal and neonatal health status so as to provide referential significance for reducing CDMR rate and improving postpartum maternal and neonatal health status and breastfeeding rate.Methods:In the prospective, single-center and controlled study, a total of 82 primiparas undergoing antenatal examination and delivery in South Binhu Hospital of Hefei First People′s Hospital were enrolled as the research objects between January 2020 and December 2021 by convenience sampling method, including 41 cases given routine health care in routine group between January and December 2020 and 41 cases given high-efficiency CPC combined with IKAP health education on basis of routine group in combination group between January and December 2021. The cognition of cesarean section, delivery modes, incidence of postpartum complications, neonatal complications and breastfeeding between the two groups were compared.Results:The age of the routine group was (26.71 ± 2.18) years old, and the age of the combination group was (27.16 ± 1.79) years old. The proportions of correct cognition, partially correct cognition and incorrect cognition to cesarean section in combination group were 73.17% (30/41), 21.95% (9/41), 4.88% (2/41), and 53.66% (22/41), 26.83% (11/41), 19.51% (8/41) in routine group, and the difference between the two groups was statistically significant ( Z = 4.22, P<0.05). The incidence of cesarean section and CDMR in combination group was 24.39% (10/41) and 1/10, lower than that in routine group [46.34% (19/41), 10/19], and the difference between the two groups was statistically significant ( χ2 = 4.32, P<0.05; Fisher′s exact test, P = 0.049 ). The total incidence rates of postpartum complications of primiparas and neonatal complications in the combination group were 4.88%(2/41) and 7.32%(3/41), lower than 12.20%(5/41) and 12.20%(5/41) in the routine group, and the differences between the two groups were not statistically significant (Fisher′s exact test, P = 0.432, 0.712). The scores of functional health literacy, communicative health literacy and critical health literacy in combination group were (85.73 ± 4.09), (51.93 ± 4.72) and (58.63 ± 4.32) points, higher than those in routine group [(80.17 ± 5.26), (46.37 ± 5.11) , (52.71 ± 5.07) points], and the difference between the two groups was statistically significant ( t = 5.34, 5.12, 5.69, all P<0.01). At 3 months after delivery, exclusive breastfeeding rate, milk powder feeding rate and mixed feeding rate in combination group were 58.54% (24/41), 7.32%(3/41), 34.15(14/41), higher than 26.83% (11/41), 29.27(12/41), 43.90%(18/41) in routine group, and the difference between the two groups was statistically significant ( χ2 = 10.73, P<0.05). Conclusions:High-efficiency CPC combined with IKAP health education can reduce incidence of CDMR, decrease maternal and neonatal complications, enhance maternal postpartum health literacy and improve breastfeeding rate in primiparas by improving correct cognition to cesarean section. It is worthy of clinical application.

Influence of Escherichia coli in the intestine on short-term prognosis in patients with acute ischemic stroke:a primary study / 中华老年心脑血管病杂志

Objective To detect the content of intestinal Escherichia coli(E.coli)in patients with acute ischemic stroke(AIS)and to analyze the relationship between the bacteria and short-term prognosis of patients with cerebral stroke.Methods A total of 75 elderly AIS patients admitted to our department from March to December 2022 were enrolled,and divided into good prognosis group(47 cases)and poor prognosis group(28 cases)according to the results of modified Rankin scale 3 months after discharge.Multivariate logistic regression analysis was used to analyze the factors affecting the prognosis of the patients,and ROC curve analysis was employed to analyze the predictive value of the intestinal bacterial content for the short-term prognosis of stroke pa-tients.Results The NIHSS score at admission and E.coli content were significantly higher in the poor prognosis group than the good prognosis group(P＜0.01).Multivariate logistic regression analysis showed that NIHSS score at admission(OR=1.302,95％CI:1.077-1.573,P=0.006)and E.coli content(OR=2.803,95％CI:1.454-5.404,P=0.002)were independent risk factors for short-term poor prognosis in the AIS patients.ROC curve analysis indicated that the AUC value was 0.758 for E.coli content,0.718 for NIHSS score,and 0.818 when the 2 indicators combined together.Conclusion Intestinal E.coli content and NIHSS score may be related to the poor prog-nosis of elderly AIS patients.The higher the content of E.coli is,the worse the recovery of neuro-logical function,which affects the short-term prognosis of the patients.

Altered gray matter volume and resting-state functional connectivity in migraine patients without aura / 中华神经科杂志

Objective:To investigate the underlying neuroimaging mechanism of migraine without aura (MwoA) by using methods of voxel-based morphometry (VBM) and resting-state functional connectivity (FC).Methods:Twenty-five MwoA patients admitted to Department of Neurology, the Second Affiliated Hospital of Xuzhou Medical University from September 2020 to June 2023 were recruited as MwoA group, and 22 volunteers were recruited as healthy control (HC) group. Demographic, clinical characteristics, scores of Hamilton Anxiety Scale (HAMA), Hamilton Depression Rating Scale (HAMD) and Montreal Cognitive Assessment (MoCA) of all subjects were collected; MwoA patients also received Migraine Disability Assessment Questionnaire, Headache Impact Test-6 and headache Visual Analogue Scale assessments. All subjects underwent high-resolution 3D-T 1 and resting-state functional magnetic resonance imaging scanning. The SPM12 software was used to compare the difference in gray matter volume (GMV) between the 2 groups by VBM method. The GRETNA software was adopted to calculate the whole brain FC with anatomical automatic labeling 90 as the regions of interest, and the difference in FC between the 2 groups was statistically analyzed by two-sample t-test. Pearson partial correlation was used to analyze the correlation between brain GMV and FC changes and clinical features and scale scores of MwoA patients. Results:There existed no statistically significant difference between the 2 groups in age, gender, education, scores of HAMA, HAMD and MoCA (all P>0.05). Migraine Disability Assessment Questionnaire, Headache Impact Test-6 and headache Visua Analogue Scale scores of MwoA patients were (8.86±4.55), (50.27±6.35) and (6.68±1.73). Compared with the HC group, GMV was significantly decreased in the right superior frontal gyrus (SFG), right cingulate gyrus (CG) and left thalamus in the MwoA group ( P<0.05, false discovery rate corrected). In addition, the MwoA group showed decreased FC between left thalamus and right cuneus, left lingual gyrus (LG) and bilateral precuneus; decreased FC between right thalamus and right cuneus, right LG and right precuneus; decreased FC between right cuneus and left precuneus and right SFG; decreased FC between left LG and bilateral precuneus, decreased FC between right LG and right precuneus and left SFG; decreased FC between left precuneus and bilateral SFG, and between right precuneus and right SFG (edge P<0.001, component P<0.05, network-based statistics correction, interation=2 000). In MwoA patients, the FC (z-value) between left thalamus and right cuneus was negatively correlated with the duration of disease ( r=-0.530, P=0.011). Conclusions:MwoA patients showed decreased GMV in right SFG, CG and left thalamus. In MwoA patients, FC between thalamus and visual network (VN) and default mode network (DMN) was significantly decreased, and FC among VN, DMN and executive control network was significantly decreased. These changes in brain structure and function may be an adaptive change in the central sensitivity and responsiveness to pain stimuli, and may be an important neuroimaging mechanism of MwoA.

Effect of Sargassum and Glycyrrhizae Radix et Rhizoma Incompatible Pair with Haizao Yuhutang on Oxidative Stress in Liver of Goiter Rats / 中国实验方剂学杂志

ObjectiveTo observe the effects of Sargassum and Glycyrrhizae Radix et Rhizoma incompatible pair with the Haizao Yuhutang （HYT） on oxidative stress in the liver of goiter rats under the condition of 2 times the dose limit of the Pharmacopoeia of the People's Republic of China 2020. MethodA total of 128 male Wistar rats were randomly divided into a blank group， a model group， a euthyrox group （20 μg·kg-1）， a HYT group （12.06 g·kg-1）， a HYT without Sargassum （HYT-H） group （9.90 g·kg-1）， a HYT without Glycyrrhizae Radix et Rhizoma （HYT-G） group （10.26 g·kg-1）， a HYT without Sargassum and Glycyrrhizae Radix et Rhizoma （HYT-HG） group （8.10 g·kg-1）， and a Sargassum and Glycyrrhizae Radix et Rhizoma （HG） group （3.96 g·kg-1）. The blank group was given deionized water by gavage， and the others were given propylthiouracil （PTU） to replicate the goiter pathological model. Euthyrox was taken as a positive control drug， and the rest of the Chinese medicine groups were given the corresponding decoction by gavage， the material was collected 12 hours after the last dose. The serum levels of aspartate aminotransferase （AST）， alanine aminotransferase （ALT）， alkaline phosphatase （ALP）， and the contents of superoxide dismutase （SOD）， glutathione peroxidase （GSH-Px）， malondialdehyde （MDA）， reactive oxygen species （ROS） in liver tissue were detected in each group. The pathological changes in the liver were observed via hematoxylin-eosin （HE） staining. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was utilized to detect the mRNA expressions of Kelch-like Ech-associated protein 1 （Keap1）， nuclear factor E2-related factor 2 （Nrf2）， heme oxygenase-1 （HO-1）， p53 and Caspase-3 in liver tissues. Western blot was adopted to detect the protein expressions of Nrf2 and HO-1 in liver tissues in oxidative stress-related signaling pathways. ResultCompared with control group， the model group showed significantly increased serum ALT level and contents of MDA and ROS in liver tissues （P<0.05， P<0.01）， significantly reduced activities of SOD and GSH-Px in the liver （P<0.01）， significantly increased mRNA expression of Keap1 （P<0.01）， and significantly decreased mRNA and protein expressions of Nrf2 and HO-1 （P<0.05， P<0.01）. Compared with the model group， the HYT group manifested significantly reduced serum levels of AST， ALT， and ALP （P<0.05， P<0.01）， significantly reduced contents of MDA and ROS in liver tissue （P<0.01）， significantly increased the activities of SOD and GSH-Px （P<0.01）， significantly decreased mRNA expressions of Keap1， p53， and Caspase-3 （P<0.01）， and significantly increased mRNA and protein expressions of Nrf2 and HO-1 （P<0.05， P<0.01）. ConclusionUnder the condition of 2 times the dose limit of the Pharmacopoeia of the People's Republic of China 2020， Sargassum and Glycyrrhizae Radix et Rhizoma incompatible pair with the HYT on oxidative stress in the liver of goiter rats had different effects. The HYT that contains Sargassum and Glycyrrhizae Radix et Rhizoma has a protective effect on the liver of goiter rats， and the effect is better than that of the HG group， the euthyrox group， and the incomplete groups. Its mechanism may be related to activating the Nrf2/HO-1 signaling pathway to alleviate liver oxidative stress and inhibiting the p53/Caspase-3 signaling pathway to reduce hepatocyte apoptosis.

Effect of mesenchymal stem cells combined with immunosuppressants on immune rejection in a rat model of liver transplantation / 临床肝胆病杂志

ObjectiveTo investigate the effect of mesenchymal stem cells （MSCs） combined with immunosuppressants （IS） on immune rejection in a rat model of liver transplantation. MethodsF344 rats were divided into Normal group （without any intervention）， PS group （injected with an equal volume of normal saline）， MSC group （injected with MSC）， IS group （injected with IS）， and MSC+IS group （injected with MSC and IS）， with 8 rats in each group. For all rats except those in the Normal group， the Kamada’s double-cuff method was used to establish a model of orthotopic liver transplantation， without reconstruction of the hepatic artery. HE staining and Masson staining were performed for rat liver tissue， and the degree of liver fibrosis was analyzed； immunohistochemical experiments were used to measure the infiltration of T cells and NK cells， and immunofluorescence assay was used to analyze macrophage M2 polarization. A one-way analysis of variance was used for comparison of continuous data between multiple groups， and the least significant difference t-test was used for further comparison between two groups. The Kaplan-Meier method was used to plot survival curves， and the log-rank test was used for survival analysis. ResultsCompared with the PS group， the MSC+IS group had a significantly prolonged survival time （P<0.01）， and the MSC group， the IS group， and the MSC+IS group had a significant improvement in the histological structure of the liver and a significant reduction in the degree of liver fibrosis （all P<0.000 1）， as well as a significant reduction in the infiltration of NK and T cells （all P<0.000 1） and a significant increase in the degree of macrophage M2 polarization （all P<0.000 1）. The MSC+IS group had a significantly better effect than the MSC group and the IS group. ConclusionMSCs combined with IS can improve liver histopathology， reduce inflammatory cell infiltration， promote macrophage M2 polarization， and exert an immunosuppressive effect in rats after liver transplantation.

Effect of the timing of double-dose pronase administration on the effect of magnetically controlled gastric capsule endoscope / 中国内镜杂志

Objective To investigate the effect of the timing of pronase on the quality of magnetically controlled gastric capsule endoscope(MCE).Methods 225 patients from February 2021 to March 2022 were randomly assigned to 3 groups,40 000 u of oral pronase 40 min before examination in Group A,20 000 u of oral pronase for 60 and 40 min before the examination in Group B,20 000 u of oral pronase for 40 and 20 min before examination in Group C.Gastric cavity cleanliness and gastric mucosa visualisation scores(1 to 4)were recorded for the six regions of the stomach and the sum of the scores was calculated.The detection rate of gastric lesions such as gastric polyps and the time of gastric examination were also recorded.Results 221 patients completed the study.In the mucosal visualization score,group C scored(23.56±1.37)points,which was higher than that in group A's(22.56±1.28)points and group B's(23.00±1.33)points.The difference was statistically significant(P<0.05).In the gastric cavity cleanliness score,group C scored(21.44±2.35)points,which was higher than that in group A's(20.11±2.04)points.The difference was statistically significant(P<0.01).In the total score of cleanliness and mucosal visualization score of the proximal stomach(cardia and fundus),group C was higher than group A and group B,and the difference was statistically significant(P<0.05).In the detection rate of lesions,the detection rates of gastric polyps and erosion in group C were 17.8%and 49.3%,respectively,which were higher than group A's(6.8%and 29.7%)and group B's(9.5%and 31.1%).The differences were statistically significant(P<0.05).The gastric observation time in group C was shorter than that in group A and group B,and the difference was statistically significant(P<0.05).Conclusions Oral administration of 20 000 u of pronase in divided doses 40 and 20 min before the examination can enhance the quality of magnetically controlled gastric capsule endoscope.

Analysis of the impact of patients ages on propofol dosage in painless gastroscopy / 中国内镜杂志

Objective To analyze the impact of patients ages on propofol dosage in painless gastroscopy.Methods A retrospective analysis was conducted on the clinical data of 158 painless gastroscopy patients from January 2017 to June 2020.They were divided into the young group(18～44 years old,n = 57),the middle-aged group(45～59 years old,n = 51),and the elderly group(≥60 years old,n = 50)based on their age.The anesthesia status and safety of each group were compared.Results The results showed that the dosage of propofol,average total dosage of propofol,MAP,HR,RR,SpO2 levels in the young group were higher than those in the middle-aged and elderly groups when consciousness disappeared,and the middle-aged group was higher than the elderly group;The onset time,anesthesia recovery time,orientation recovery time,and departure time in the young group of patients were shorter than those in the middle-aged and elderly groups,and the middle-aged group was shorter than the elderly group(P<0.05).The incidence of airway obstruction,hypoxemia,mandible support,mask ventilation,adverse cardiovascular events,sedation related adverse events,and incidence of obstructed endoscopy in the elderly group were higher than those in the young and middle-aged groups.The incidence of smooth endoscopy was lower than that in the young and middle-aged groups(P<0.05).Conclusion Aging may increase the dosage of propofol in patients underwent painless gastroscopy under anesthesia,prolong the onset time,anesthesia recovery time,orientation recovery time,and departure time,increase stress reactions and adverse reactions,and strengthen monitoring for elderly patients in clinical practice.

Current Situation and Consideration of Refinement of Hospital Team Service based on Value-based Medicine / 中国医院管理

Objective To describe and analyze the current situation of the four same type of departments in an hospital in order to provide a reference for the construction of"the most cost-effective medical care".Methods The CN-DRG were used to automatically group and compare the medical capacity and inpatient service efficiency of the hospital department groups,and in the refined analysis,one DRG disease group of in situ cancer and non-malignant disease loss uterine surgery and single species uterine fibroid was included,and the Kruskal-Wallis H test was used to further compare the differences in length of stay and various costs.Results It included a total of 22630 patients,whose weights varied from a maximum of 3948.62 in diagnostic group 1 to a minimum of 133.55 in diagnostic group 11.The cost consumption indexes ranged from a minimum of 0.89 in diagnostic group 5 to a maximum of 1.04 in diagnostic group 2,while the time consumption indexes ranged from a minimum of 0.48 in diagnostic group 11 to a maximum of 0.81 in diagnostic group 5.When comparing the diagnostic groups,there were statistically significant differences(P＜0.05)in hospitalization days,total cost,diagnostic cost,therapeutic cost,and cost of supplies.Specifically,when comparing the diagnostic and treatment groups within departments,the differences in hospitalization days and all costs were statistically significant(P＜0.05)in departments 1 and 2,the differences in diagnostic cost,therapeutic cost,and cost of supplies were statistically significant(P＜0.05)in department 3.Conclusion There exists a notable disparity in the extent to which each diagnostic and treatment group contributes to the hospital's service capacity and cost variability.Consequently,it is necessary to reasonably evaluate the length of hospital stay and medical cost of patients to achieve the highest cost-effective medical treatment.

Evaluation of right ventricular function in patients with hypertrophic cardiomyopathy and heart failure with preserved ejection fraction by the ratio of tricuspid annular plane systolic excursion to pulmonary artery systolic pressure / 中华超声影像学杂志

Objective:To evaluate the value of the ratio of tricuspid annular plane systolic excursion to pulmonary artery systolic pressure (TAPSE/PASP) in evaluating right ventricular function of patients with hypertrophic cardiomyopathy (HCM) and heart failure with preserved ejection fraction (HFpEF).Methods:A total of 74 patients with HCM and HFpEF and 22 healthy individuals who visited the First Affiliated Hospital of Zhengzhou University from January 2021 to January 2023 were included in this study. The HCM patients with HFpEF were divided into three groups based on the tertiles of the TAPSE/PASP (low group: <0.280 0 mm/mmHg; middle group: 0.280 0-0.476 2 mm/mmHg; high group: >0.476 2 mm/mmHg). Conventional echocardiographic parameters were collected, and two-dimensional speckle tracking technology was used to obtain right ventricular strain parameters. The differences in parameters among the groups were compared, and the correlations between TAPSE/PASP and clinical parameters and right ventricular function parameters were analyzed.Results:The results of difference analysis showed that there were significant differences in 6-minute walking test, New York Heart Association grade (NYHA grade), incidence of atrial fibrillation, left atrial area (LAA), left ventricular global longitudinal strain (LVGLS), TAPSE, PASP, right ventricular fractional area change (RVFAC), right ventricular global longitudinal strain (RVGLS), right ventricular free wall strain (RVFWST) and cardiac magnetic resonance right ventricular ejection fraction (CMR-RVEF) among the three groups. The results of correlation analysis and multiple linear regression analysis showed that the TAPSE/PASP was positively correlated with 6-minute walking distance, RVFAC, tricuspid annulus peak systolic velocity (RV s′), and CMR-RVEF ( r=0.449, 0.284, 0.358, 0.577; all P<0.05). It was negatively correlated with N-terminal pro-brain natriuretic peptide (NT-proBNP), NYHA grade, LAA, mitral early diastolic peak velocity / mitral annulus early diastolic peak velocity (LV E/e′), LVGLS, RVGLS, RVFWST and tricuspid early diastolic peak velocity / tricuspid annulus early diastolic peak velocity (RV E/e′) (r/ rs=-0.336, -0.349, -0.468, -0.452, -0.444, -0.339, -0.405, -0.320; all P<0.05). The LAA and CMR-RVEF correlated independently with TAPSE/PASP(all P<0.05). Conclusions:The TAPSE/PASP can provide an early, simple, rapid, and convenient evaluation of right ventricular function in patients with HCM and HFpEF, so as to guide clinical treatment and monitoring disease progression.

Esketamine induced apoptosis in human breast cancer cell line MDA-MB-468 and its mechanism / 中华内分泌外科杂志

Objective:To explore whether esketamine (ESK) can inhibit the proliferation and induce apoptosis of breast cancer cells, and explore the mechanism.Methods:CCK-8 assay was used to detect the inhibitory effect of ESK on the proliferation of breast cancer cells. Annexin V/PI staining was used to detect the morphological changes of cells; Apoptosis and reactive oxygen species were detected by flow cytometry. Western blot was used to detect apoptosis and pathway expression.Results:CCK-8 experiment results proved that ESK could inhibit the proliferation of breast cancer cells in a time-dependent manner. The survival rate of MDA-MB-468 cells treated with ESK at 20 μM was (35.47±2.61) %, which was statistically different from that treated with vinorelbine at the same concentration ( P<0.05). The IC50 value of ESK on MDA-MB-468 cells was (14.54±2.12) μM. After treatment with ESK, the mitochondrial membrane potential was significantly reduced. In the protein level, the expression of Cytochrome C, Bax and Caspase-3 was up-regulated, and the expression of Bcl-2 was down regulated, which induced the mitochondrial dependent apoptosis of MDA-MB-468 cells. ESK could up regulate the level of reactive oxygen species in MDA-MB-468 cells and regulate the expression of PI3K/AKT signaling pathway. Conclusions:ESK can inhibit the proliferation and migration of breast cancer cells and induce them to play a mitochondrial dependent apoptosis. Its mechanism is achieved by up regulating the level of ROS in breast cancer cells, thereby regulating the PI3K/AKT signaling pathway, which provides a theoretical basis for the development and utilization of Aln.

Study of the effect of mid-ventricular obstruction on left ventricular systolic function in patients with hypertrophic cardiomyopathy by four-dimensional automatic left ventricular quantitation technology / 中华超声影像学杂志

Objective:To investigate the effect of mid-ventricular obstruction (MVO) on left ventricular systolic function in patients with hypertrophic cardiomyopathy(HCM) by four-dimensional automatic left ventricular quantitation technology(4D Auto LVQ).Methods:Fifty-seven hypertrophic obstructive cardiomyopathy patients were selected from December 2020 to October 2022 in the First Affiliated Hospital of Zhengzhou University. According to the presence of MVO, HCM patients were divided into two groups: HCM 1 group, HCM without MVO ( n=34); HCM 2 group, HCM with MVO ( n=23). In addition, 25 healthy subjects in the same period were selected as the control group. Conventional ultrasound parameters were collected, and 4D Auto LVQ technology was used to obtain the mechanical parameters of left ventricular myocardium, including left ventricular longitudinal strain (GLS), circumferential strain (GCS), area strain (GAS), radial strain (GRS), segmental longitudinal strain (SLS) and area strain (SAS). The differences of these parameters among the three groups were compared. Results:①Compared with the control group, the thickness of the maximum basal segment of interventricular septum, the thickness of the middle segment of the maximum interventricular septum, the thickness of the apical segment of the interventricular septum, the thickness of the left ventricular posterior wall and left atrium diameter were significantly increased. Six-minute walk distance and the left ventricular end-diastolic diameter was decreased in the two groups of HCM(all P<0.05). Left ventricular outflow tract gradients in HCM 1 group was higher than HCM 2 group( P<0.05), but there was no significant difference in left ventricular ejection fraction among the three groups( P>0.05). There was significant difference in the incidence of left ventricular apical aneurysm among the three groups( P<0.05). ②Compared with the control group, the GLS in both HCM groups was lower, and it was lower in the HCM 2 group than in the HCM 1 group(all P<0.05) the GRS and GAS in both HCM groups were lower than in the control group ( P<0.05), and there was no significant difference between the two groups of HCM, and there was no significant difference in GCS among the three groups(all P>0.05). ③Compared with the control group, the SLS of basal segment, middle segment, apical cap, posterior septum, inferior wall and lateral wall in HCM group were significantly lower than those in control group. The SLS of apical segment of posterior septum, anterior septum, anterior wall, posterior wall, inferior wall and apical segment of posterior septum, lateral wall and inferior wall in HCM 2 group were significantly lower than HCM 1 group(all P<0.05), but there was no significant difference in SLS of posterior septum, anterior septum, anterior wall, lateral wall and inferior wall between the two groups(all P>0.05). ④Compared with the control group, the SAS of posterior septal basal segment, middle segment, anterior septal middle segment, anterior wall basal segment, middle segment, apical segment, lateral wall basal segment, middle segment, apical segment, posterior wall basal segment, middle segment, inferior wall basal segment, middle segment and apical cap in HCM groups were significantly lower than the control group(all P<0.05), but there was no significant difference in SAS between the two groups of HCM( P>0.05). Conclusions:4D Auto LVQ can quantitatively evaluate the damage of MVO on the left ventricular systolic function in patients with HCM, especially for the evaluation of local myocardial function damage in the medial segment and apical segment.

Characteristics of vaginal microbiota in pregnant women with premature rupture of membranes and establishment of prediction model / 中华微生物学和免疫学杂志

Objective:To study the characteristics of vaginal microbiota in pregnant women with premature rupture of membranes (PROM) and to establish prediction models for PROM.Methods:This study involved 35 women with preterm premature rupture of membranes (PPROM), 180 with term premature rupture of membranes (TPROM) and 255 term birth cases without premature rupture of membranes (TBWPROM, control group). The V3-V4 hypervariable region sequences in the vaginal samples collected at 16-28 weeks of gestation were detected by 16S rRNA gene next-generation sequencing. The differences in Alpha and Beta diversity, and the attributes and metabolic function prediction of each recognized species among the three groups were analyzed. Subsequently, a random forest model was used to establish the prediction models for PROM using vaginal microbiota species and environmental risk factors.Results:Compared with the control group, the Alpha diversity of the PPROM group was higher (Observed features, P=0.022; Faith_pd index, P=0.024) and Beta diversity was also significantly different (Unweighted UniFrac, P=0.010; Jaccard index, P=0.008). In PPROM cases, Megasphaera genomosp. typeⅠ was significantly increased ( P=0.017) and Lactobacillus mulieris was significantly decreased ( P=0.003). In the patients with TPROM, Megasphaera was significantly increased ( P=0.009) and Lactobacillus mulieris was significantly decreased ( P=0.002). In terms of functional pathways, sulfur oxidation ( P=0.021), methanogenesis from acetate ( P=0.036), L-histidine biosynthesis ( P=0.009), adenosylcobalamin biosynthesis ( P=0.041) and fucose degradation ( P=0.001) were significantly increased in patients with PPROM; L-histidine biosynthesis ( P<0.001) and fucose degradation ( P=0.030) were significantly increased in patients with TPROM. The prediction models were established using the random forest model with vaginal microbiota species and environmental risk factors and the prediction model for PPROM performed well [AUC: 0.739 (95%CI: 0.609-0.869), sensitivity: 0.928, specificity: 0.659, positive predictive value: 0.750, negative predictive value: 0.906], which had a certain reference value. Conclusions:Vaginal microbiota might be related to the development and progression of PROM. Studying the differences in vaginal microbiota might provide a new idea for the prevention and treatment of PROM. Functional prediction provided a direction for further research on the mechanism of PROM. The established prediction model could prevent the occurrence of PPROM and promote maternal and infant health.

Protective Effect of Flos Puerariae，Hoveniae Semen， and Their Compatibility on Acute Alcoholic Gastric Mucosal Injury in Mice and Mechanism / 中国实验方剂学杂志

ObjectiveTo explore the improvement effect of Flos Puerariae， Hoveniae Semen， and their compatibility on acute alcoholic gastric mucosal injury， and lay a foundation for further development of Flos Puerariae， Hoveniae Semen， and their compatibility in the prevention and treatment of alcohol-induced multiple organ injury. MethodThe acute alcohol-induced gastric mucosal injury model of mice was established by multiple intragastric administration of 56% Hongxing Erguotou liquor （15 mL·kg-1）. A total of 120 male ICR mice were randomly divided into 8 groups， namely， the blank group， model group， omeprazole group （0.026 g·kg-1）， Flos Puerariae-Hoveniae Semen （compatibility） high， medium， and low-dose groups （29.2，14.6， 7.3 g·kg-1）， Flos Puerariae group （19.5 g·kg-1）， and Hoveniae Semen group （19.5 g·kg-1）， with 15 mice in each group. After one week of adaptive feeding， the animals were pre-administrated with the corresponding drug at the rate of 10 mL·kg-1 for 3 d. From the 4th day， after 1 h of administration， Erguotou liquid was administrated at the rate of 15 mL·kg-1 and the blank group was administrated with the same volume of deionized water to record the drunkenness and sober up time. The administration was lasted for 3 d. One hour after the last administration， the eyeballs were removed and the mice were sacrificed. The concentration of ethanol in serum was determined by gas chromatograph， and the activity of ethanol dehydrogenase （ADH） in gastric mucosa was determined by ultraviolet-vis spectrophotometer. Hematoxylin-eosin （HE） staining was used to observe the pathological changes in gastric mucosa. Serum inflammatory factors were determined by enzyme-linked immunosorbent assay （ELISA）. The mRNA expression of nuclear transcription factor-κB （NF-κB） p65 and NF-κB inhibitory protein α （IκBα） were detected by real-time polymerase chain reaction （Real-time PCR）. ResultAs compared with the normal group， the content of interleukin-6 （IL-6）， interleukin-1β （IL-1β）， and tumor necrosis factor-α （TNF-α） in serum of mice in the model group was increased （P<0.05）， the mRNA expression of NF-κB p65 in gastric mucosa tissues was increased （P<0.01）， and the mRNA expression of IκBα was decreased （P<0.01）. As compared with the model group， the drunkenness time of the omeprazole group， high and medium-dose compatibility groups， and Flos Puerariae group was prolonged （P<0.05）， the sober up time of the high and medium-dose compatibility groups was shortened （P<0.05）， the ethanol concentration in the serum of the high-dose compatibility group was decreased （P<0.05）， the ADH activity in the gastric mucosa of the omeprazole group and high and medium-dose compatibility groups was increased （P<0.05）， the macroscopic injury score of the high， medium， and low-dose compatibility groups and Flos Puerariae group was decreased （P<0.05）， the score of pathological injury in the omeprazole group， high， medium， and low-dose compatibility groups， and Flos Puerariae group was decreased （P<0.01）， the expression of IL-6 in serum of all drug groups was decreased （P<0.05）， the expression of IL-1β in serum of the omeprazole group， high， medium， and low-dose Flos Puerariae groups， and Hoveniae Semen group was decreased （P<0.05）， the expression of TNF-α in serum of high and medium-dose groups was decreased （P<0.05）， the mRNA expression of NF-κB p65 in gastric mucosa tissues of all drug groups was decreased （P<0.05）， and the mRNA expression of IκBα in gastric mucosa tissues of the omeprazole group and high， medium， and low-dose compatibility groups was increased （P<0.05）. As compared with the high-dose compatibility group， the drunkenness time in the low-dose compatibility group and Hoveniae Semen group was shortened （P<0.01）， the sober up time in the Flos Puerariae and Hoveniae Semen groups was prolonged （P<0.01）， the concentration of ethanol in the serum of the medium and low-dose compatibility groups， Flos Puerariae group， and Hoveniae Semen group increased （P<0.05）， the macroscopic injury score of the medium and low-dose compatibility groups and Hoveniae Semen group was increased （P<0.05）， the pathological injury score of the medium and low-dose compatibility groups， Flos Puerariae group， and Hoveniae Semen group was increased （P<0.01）， the content of IL-1β in serum of low-dose compatibility group， Flos Puerariae group， and Hoveniae Semen group was increased （P<0.01）， and the mRNA expression of IκBα in gastric mucosa of the Flos Puerariae group and Hoveniae Semen group was decreased （P<0.05）. As compared with the medium-dose compatibility group， the drunkenness time in the Hoveniae Semen group was shortened （P<0.05）， the sober up time in the Flos Puerariae group was prolonged （P<0.05）， the pathological injury score in the Flos Puerariae group and Hoveniae Semen group was increased （P<0.01）， and the content of IL-1β in serum of the low-dose compatibility group， the Flos Puerariae group， and Hoveniae Semen group was increased （P<0.05）. As compared with the low-dose compatibility group， the pathological injury score of the Hoveniae Semen group was increased （P<0.05）. ConclusionFlos Puerariae， Hoveniae Semen， and their compatibility play a role in preventing and treating acute alcoholic gastric mucosal injury in mice， which may be related to the inhibition of the expression of NF-κB signal pathway in gastric mucosa， and the high-dose compatibility group has the optimal effect.

Qualitative study on spiritual needs of young and middle-aged patients with shrinking man syndrome / 中国实用护理杂志

Objective:To determine the spiritual needs of shrinking man syndrome (SMS) in young and middle-aged patients, and to provide reference for determining targeted intervention plans.Methods:From May to July, 2021, 14 young and middle-aged patients with SMS who received hyperparathyroidism thermal ablation in the Interventional Medicine Department of China-Japan Friendship Hospital were selected by purpose sampling method. Qualitative research phenomenology was used to conduct semi-structured in-depth interviews, and the interview data were analyzed by Colaizzi 7-step analysis method.Results:There were 4 themes and 14 sub-themes: "understanding and self-acceptance of illness" (attribution to illness; disease uncertainty; acceptance and illness), "need for social support" (love and respect; connection and companionship; family support; medical support; patient support), "life value and sense of meaning" (life meaning and goal; self-esteem; religious belief), "self-actualization and transcendence" (hope for improvement; eager for miracles; realize your value).Conclusions:Medical staff should pay attention to the spiritual needs of young and middle-aged patients with SMS, and specifically meet their spiritual needs during diagnosis, treatment, nursing and follow-up, so as to improve the patients′ sense of life meaning and value, and help them to better survive with disease and return to society.

Fabrication of edge-curled petals-like covalent organic frameworks and their properties for extracting indole alkaloids from complex biological samples / 药物分析学报

In this study,a functionalized covalent-organic framework(COF)was first synthesized using porphyrin as the fabrication unit and showed an edge-curled,petal-like and well-ordered structure.The synthesized COF was then introduced to prepare porous organic polymer monolithic materials(POPMs).Two com-posite POPM/COF monolithic materials with rod shapes,referred to as sorbent A and sorbent B,were prepared in stainless steel tubes using different monomers.Sorbents A and B exhibited relatively uniform porous structures and enhanced specific surface areas of 153.14 m2/g and 80.01 m2/g,respectively.The prepared composite monoliths were used as in-tube solid-phase extraction(SPE)sorbents combined with HPLC for the on-line extraction and quantitative analytical systems.Indole alkaloids(from Catharanthus roseus G.Don and Uncaria rhynchophylla(Miq.)Miq.Ex Havil.)contained in mouse plasma were extracted and quantitatively analyzed using the online system.The two composite multifunctional monoliths showed excellent clean-up ability for complex biological matrices,as well as superior selec-tivity for target indole alkaloids.Method validation showed that the RSD values of the repeatability(n=6)were≤3.46％,and the accuracy expressed by the spiked recoveries was in the ranges of 99.38％-100.91％and 96.39％-103.50％for vinca alkaloids and Uncaria alkaloids,respectively.Furthermore,sorbents A and B exhibited strong reusability,with RSD values≤5.32％,which were based on the peak area of the corresponding alkaloids with more than 100 injections.These results indicate that the composite POPM/COF rod-shaped monoliths are promising media as SPE sorbents for extracting trace compounds in complex biological samples.

Discontinuation of nucleoside/nucleoside analogues therapy in compensated patients with hepatitis B cirrhosis after HBsAg negative conversion / 中华临床感染病杂志

Objective:To evaluate the safety of discontinuing nucleoside/nucleoside analogue (NAs) therapy in patients with compensated hepatitis B cirrhosis after HBsAg negative conversion.Methods:A total of 3 783 patients with hepatitis B cirrhosis in compensated stage were treated with NAs at Taizhou Hospital, Taizhou Municipal Hospital and Taizhou Enze Hospital from January 2008 to December 2020. The clinical data and laboratory tests results of 85 patients with HBsAg negative conversion were retrospectively analyzed, including 36 cases discontinued the drug, and 49 continued to use drug. Chi-square test and rank-sum test were used for data analysis.Results:During the 24 and 48 months of follow-up, the ALT levels were within the normal range in both groups. There were no significant differences in positive rates of anti-HBs and HBeAg ( χ2=0.75, 0.39 and 0.90, P=0.78 0.84 and 0.34; χ2=0.40, 0.00 and 0.00, P=0.84, 1.00 and 1.00) between two groups. After 48 months of follow-up, 2 cases of primary liver cancer occurred in the discontinuation group and no primary liver cancer occurred in the continuation group ( χ2=0.89, P=0.34). Throughout the follow-up, HBsAg remained negative and HBV DNA load was below the lower limit of detection in both groups. Conclusions:Discontinuation of NAs can be considered after the HBsAg negative conversion in patients with compensated hepatitis B cirrhosis.

Analysis of clinical, pathological and gene mutation characteristics in 11 cases of nemaline myopathy caused by NEB gene mutation / 中华神经科杂志

Objective:To investigate the characteristics of clinical, muscle pathology and gene mutation in patients with nemaline myopathy caused by NEB gene mutation.Methods:The clinical and pathological data of patients with nemaline myopathy caused by NEB gene were collected from Neuromuscular Center of Jiaozuo People′s Hospital from January 1997 to January 2020. The next generation sequencing was preformed to detect NEB gene in all patients, and characteristics of gene mutation were analyzed.Results:Among the 11 patients, there were 8 males and 3 females, and 6 of them came from 2 families. The age of seeing a doctor ranged from 11 to 52 years, the age of onset was from 6 to 23 years, and the course of disease ranged from 5 to 35 years. Neurological examination showed that among the 11 patients, 8 patients had high palatal arch and long face. The muscle tone of both upperlimbs was normal, the tendon reflex was depressed, the proximal muscle strength was grade Ⅲ-Ⅴ, and the distal muscle strength was grade Ⅴ. The muscle tone of both lower extremities was reduced and the tendon reflex was absent. The proximal muscle strength was grade Ⅱ-Ⅳ and the distal muscle strength was grade Ⅲ-Ⅴ. No dysphagia or respiratory muscle involvement was found. Muscle biopsies were performed in 7 of the 11 patients, the pathological changes were muscle fibers of different sizes, circular atrophic muscle fibers and compensatory hypertrophic fibers, and occasionally denatured and necrotic muscle fibers were found. Different degrees of rod aggregation could be seen in all the 7 patients. Electron microscopic examination of 5 patients showed that there was rod aggregation between myofibrils, and most of them were located near the Z band, but no intranuclear rod was found. NEB gene was found in all 11 patients, and a total of 9 different mutation sites were detected, including 8 in exon region and 1 in intron region. Among them, c.21522+3A>G was found in 10 cases, c.1623delT was found in 3 cases and c.17611C>T was found in 3 cases. There was 1 case of c.4417C>T, c.2549delA, c.21065dupA, c.3520G>A, c.20943G>A, c.192G>A respectively.Conclusions:The clinical phenotype of nemaline myopathy caused by NEB gene has great heterogeneity. Muscle pathology shows that rod aggregation is an important basis for the diagnosis of this disease. Mutation c.21522+3A>G in intron is the most common mutation in this group of NEB gene. And the novel mutation sites of NEB gene are respectively c.17611C>T, c.2549delA, c.3520G>A, c.21065dupA, c.20943G>A and c.192G>A.

Effects of resilience on posttraumatic growth in patients with refractory secondary hyperparathyroidism: the mediating role of hope / 中国实用护理杂志

Objective:To investigate the mediating effect of hope on resilience and post traumatic growth (PTG) in patients with refractory secondary hyperparathyroidism (rSHPT).Methods:It was convenient to select rSHPT patients and non-refractory SHPT patients who received maintenance hemodialysis treatment in China-Japan Friendship Hospital from September 2018 to September 2021. Totally 495 patients with rSHPT and 1 295 patients with mild secondary hyperparathyroidism (SHPT) were surveyed by the Chinese Version of The Herth Hope Scale, the Chinese version of the Connor-Davidson Resilience Scale and the Post Traumatic Growth Rating Scale (PTGI). After matching according to the 1∶1 Propensity Score Matching (PSM), 436 cases were set in each of the two groups. The differences of hope, resilience and PTG scores between the two groups were compared. Pearson correlation analysis was used to analyze the correlation between hope, resilience and total score of PTG in rSHPT group. Regression analysis and SPSS Process mediation Model 4 were used to test the mediating effect of hope on resilience and PTG.Results:The hope score (32.16 ± 4.15), psychological resilience score (61.22 ± 14.38), and the PTG score (52.34 ± 18.92) of rSHPT patients was significantly lower than 33.41 ± 2.97 ( t=-5.72, P<0.05), 63.19 ± 7.25 ( t=-2.77, P<0.05), 57.95 ± 10.07 ( t=-6.34, P<0.05) of SHPT patients. There was a positive correlation between hope, resilience and PTG score ( r=0.671, 0.488, 0.523, all P<0.01). Regression analysis showed that resilience could positively predict PTG ( β=0.518, P<0.01). Psychological resilience positively predicted hope ( β=0.188, P<0.01). Resilience ( β=0.204, P =0.002) and hope ( β=1.442, P<0.01) could positively predict PTG. Hope played a partial mediating role in the relationship between resilience and PTG, and the mediating effect accounted for 60.23%. Conclusions:rSHPT patients generally had lower levels of hope, resilience and PTG. Resilience can affect PTG directly or indirectly through hope. Medical staff should improve the resilience and hope level of patients with rSHPT through positive psychological intervention measures, so as to enhance the positive promoting effect of psychological resilience on PTG.

Vaginal microbiota characteristics and influencing factors in normal pregnant women / 中华微生物学和免疫学杂志

Objective:To study the characteristics and influencing factors of vaginal microbiota in normal pregnant women.Methods:This study was based on a cohort of pregnant women established in Anqing Municipal Hospital Affiliated to Anhui Medical University from February 2018 to February 2020. Vaginal samples of normal pregnant women who met the inclusion and exclusion criteria were ordered by the gestational weeks at sampling. Five samples were randomly selected from each gestational week group and if the samples were less than five, all samples were included. Sequencing of the V3-V4 region of the 16S rRNA gene was performed. Dominant species were analyzed by MicrobiomeAnalyst. Alpha diversity was measured with Chao1, Observed Features, Shannon diversity, Simpson diversity, Faith_pd and Pielou′s Evenness. The dominant status of Lactobacillus was also described and compared. Multiple linear regression and logistic regression were used to analyze the factors influencing vaginal microbiota. Analysis of variance and Kruskal Wallis test were used for statistical analysis of continuous variables, and Chi-square test and Fisher′s exact test were used for categorical data. The differences were considered statistically significant when the P value was less than 0.05. Results:This study enrolled 91 pregnant women (91 vaginal samples) with an average age of (27.37±3.60) years. There were 18, 56 and 17 vaginal samples collected at the median gestational age of 11.93 weeks (the first trimester), 19.43 weeks (the second trimester) and 38.29 weeks (the third trimester), respectively. The relative abundance of Firmicutes and Lactobacillus was 91.30% and 87.67%, respectively. Lactobacillus iners and Lactobacillus crispatus had a relative abundance of 43.95% and 36.33%, respectively. Moreover, Lactobacillus iners-dominated vaginal microbiota was detected in all trimesters. The number of samples with high relative abundance of Lactobacillus iners gradually decreased with gestational age. Lactobacillus crispatus-dominated vaginal microbiota was found in the second and third trimesters and the number of samples with high relative abundance gradually increased during pregnancy. The Alpha diversity of vaginal microbiota had a decreasing trend during the gestation. There were significant differences in Pielou′s Evenness diversity index of vaginal microbiota between different smoking groups ( P<0.05) and in Shannon diversity index between different drinking groups ( P<0.05). There were significant differences in Chao1, Observed Features and Faith_pd diversity index of vaginal microbiota between pregnant women with different education ( P<0.05) and in Shannon and Simpson diversity index between different income groups ( P<0.05). Conclusions:Vaginal microbiota was dominated by Lactobacillus in normal pregnant women. The dominance of Lactobacillus iners gradually decreased, while that of Lactobacillus crispatus increased during gestation. In normal pregnant women, the Alpha diversity of vaginal microbiota was correlated with smoking, drinking, education and family annual income. Smoking cessation and drinking before pregnancy were related to lower Alpha diversity of vaginal microbiota in pregnant women, while lower education and higher family income were associated with higher Alpha diversity.

Investigation of medication adherence for superficial mycoses among students in a college based on Morisky Medication Adherence Scale / 药学实践杂志

Objective To investigate the medication adherence of military academy students with superficial mycoses. Methods A 8-item Morisky medication adherence scale (MMAS) was modified into 7-item scale to evaluate the compliance of antifungal drugs in the sick students. The reliability and validity of the scale were analyzed. Results A total of 243 questionnaires were collected, of which 242 were valid questionnaires. 90.08% of the students took topical medication and 8.68% were treated both with topical and systematic combination. High, medium and low medication adherence rates as assessed by the modified MMAS were 9.09%, 23.97% and 66.94%, respectively. The reliability analysis showed that the internal consistency coefficient (Cronbach’s α ) was 0.781，and the adjusted Cronbach’s α was 0.790, indicating the high reliability of the scale. The KMO value was 0.798, and the Bartlett’s spherical test value was 440.866, P=0.000. One factor was extracted by exploratory factor analysis. The factor loadings of the items were all above 0.5. Therefore, the high convergent validity was good. Conclusion The modified MMAS has good reliability and validity and is applicable for the evaluation of medication compliance for superficial mycoses. In this study, the military students have a low level of medication adherence for superficial mycoses. Effective measures should be taken to help students strengthen their daily medication management and improve compliance.